Bilateral central retinal artery occlusion in a patient with systemic lupus erythematosus

Systemic lupus erythematosus (SLE) is associated with a wide range of ocular manifestations. We report a case of a 20-year-old woman with newly diagnosed SLE, who awoke with bilateral simultaneous central retinal artery occlusion (CRAO). Her antiphospholipid antibody panel was normal. Vision did not recover after treatment with steroids and anticoagulation. This case suggests that such patients may be in hypercoagulable status even with negative antiphospholipid antibodies. Severe ocular complication such as CRAO may occur during the early disease process. It is important to recognize this potential risk factor and treat vigorously and early.